Multiperspective and Multimethod Evaluation of Flexible and Integrative Psychiatric Care Models in Germany: Study Protocol of a Prospective, Controlled Multicenter Observational Study (PsychCare)

Abstract

Background: New cross-sectoral mental health care models have been initiated in Germany to overcome the fragmentation of the German health care system. Starting in 2013, flexible and integrative psychiatric care model projects according to §64b SGB V German Social Law (FIT64b) have been implemented. The study “PsychCare” combines quantitative and qualitative primary data with routine health insurance data for the evaluation of these models. Effects, costs and cost-effectiveness from the perspectives of patients, relatives and care providers are compared with standard care. Additionally, quality indicators for a modern, flexible and integrated care are developed. This article describes the rationale, design and methods of the project.Methods: “PsychCare” is built on a multiperspective and multimethod design. A controlled prospective multicenter cohort study is conducted with three data collection points (baseline assessment, follow-up after 9 and 15 months). A total of 18 hospitals (10 FIT64b model and 8 matched control hospitals) have consecutively recruited in- and outpatients with pre-specified common and/or severe psychiatric disorders. Primary endpoints are differences in change of health-related quality of life and treatment satisfaction. Sociodemographic and service receipt data of the primary data collection are linked with routine health insurance data. A cost-effectiveness analysis, a mixed method, participatory process evaluation by means of qualitative surveys and the development of quality indicators are further elements of “PsychCare.”Discussion and Practical Implications: The results based on data from different methodological approaches will provide essential conclusions for the improvement of hospital based mental health care in Germany. This should result in the identification of key FIT64b elements that can be efficiently implemented into standard care in Germany and re-structure the care strongly aligned to patient needs.Clinical Trial Registration: German Clinical Trial Register, identifier DRKS 00022535.

Evaluation of a flexible and integrative psychiatric care model in a department of child and adolescent psychiatry in Tübingen, Germany: study protocol (EVA_TIBAS)

“…Further details of this procedure are described elsewhere [ 20 ] and already used in other studies [ 21 , 22 ]. All 16 possible control hospitals were sorted from best to least fit to the model hospital.…”

Settingübergreifende Behandlung in der Psychiatrie: Umsetzung spezifischer Versorgungsmerkmale an Kliniken der Modell- und Regelversorgung (PsychCare-Studie)

“…Die vorliegende Untersuchung ist Teil der "PsychCare"-Studie (Laufzeit: 07/2017 bis 06/2021; [19] [21,22].…”

“…Mit Blick auf eine potenzielle Verstetigung der Modellversorgung oder einzelner Versorgungsbestandteile gewinnt die Weiterentwicklung der Merkmale hin zu Qualitätsindikatoren an Relevanz. Derzeit werden in einem weiteren Studienteil der PsychCare-Studie Indikatoren für eine patientenzentrierte und sektorenübergreifende psychiatrische Versorgung entwickelt [19]. Ein Manual sowie das (Core-)Indikatorenset liegen bereits vor und werden in Kürze publiziert.…”

Wie erleben Nutzer*innen die Versorgung? Vom Mehrwert partizipativ-kollaborativer Forschung

“…struktur-und prozessbezogene Merkmale entwickelten, die wesentliche Abläufe der Modellversorgung fassen [14]. In der partizipativen Prozessevaluation der Psych-Care-Studie (Modul B -Laufzeit 2017-2020) [16] arbeitete ein gemischtes Team aus Forscher*innen mit und ohne EE kollaborativ zusammen, wobei letztere auf der Basis ihrer reflektierten Positionalität und akademischen bzw. beruflichen Qualifikationen mitarbeiteten.…”